PROSTAGLANDIN E(2) FOR CERVICAL RIPENING - A MULTICENTER STUDY OF PATIENTS WITH PRIOR CESAREAN DELIVERY

To evaluate the maternal and fetal outcomes of a large cohort of women treated with prostaglandin E(2) (PGE(2)) gel for cervical ripening pr ior to trial of labor after previous cesarean delivery. Beginning in 1 990 all pregnant patients with previous cesarean delivery presenting f or prenatal care at 10 California hospitals were prospectively studied . We analyzed multiple parameters to compare outcomes of cases in whic h PGE(2) gel was used to outcomes in a control group in which PGE(2) w as not used. Data were examined by X(2) testing. During the study peri od 5022 patients underwent trial of labor after prior cesarean deliver y. Of these 5022 patients, 453 (9%) were treated with PGE(2) gel. Ther e was no significant difference in the incidence of uterine rupture be tween the PGE(2) group and the control group. Indicators of maternal a nd perinatal morbidity were not significantly higher in the prostaglan din treated group. The use of PGE(2) gel for cervical ripening appears to be relatively safe in patients with prior cesarean delivery.